| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
CareFirst
| Professional | $222.24 | $222.24 | $222.24 | |
Cigna
| Professional | $191.26 | $191.26 | $191.26 | |
Kaiser Permanente
| Professional | $486.00 | $486.00 | $486.00 |